This program is a level 1. It has:

  • Target population defined with rationale based on general priorities for HIV program intervention type.
  • Formative or process evaluation or Internal evaluation.
  • Two years of results that meet or exceed stated objectives.
  • Two-three years of funding.

Level 1


Focus Areas:
Gender: Womens equity
Implemented By: Canadian Physicians for Aid and Relief
Participating Organization:Makerere University Medical School, Department of Heallthcare and Epidemiology, University of British Columbia
Region: Africa
Country: Uganda
Environment: Community/Household
Setting: Rural
Target Population: Adolescents (ages 13-17), Females
Scope: 10000 - 25000
Implementation Years: Jul 2004 - Jul 2005

Between July 2004 and July 2005 a research team discussed with girls and women individually and in focus groups the ‘wayo’ system (the role of the paternal aunt) and the importance of the role of the grandmother’s hut. The team also interviewed women and girls regarding their thoughts about their vulnerability to HIV/AIDS, the impact of the war, abductions and fatalism. They examined the potential of the 'wayo' institution in protecting young girls and women against sex abuse, HIV/AIDS and STDs in war torn northern Uganda. This was a prospective study that defined the intervention and then implementation of the 'wayo' model intervention for the prevention of HIV/AIDS and STIs, in an acceptable way in displacement camp circumstances.

Program Goals:

  • To explore the strengths and weaknesses of traditional intergenerational methods of passing on sexual knowledge and dealing with sexual matters in the context of the family.
  • To assess the effects of the conflict on the integrity of traditional Acholi systems and the applicability of the ssenga model in this context.
  • To assess, in the context of ongoing conflict, how traditional mechanisms can be applied to develop culturally sensitive HIV/AIDS programming for sexually exploited child returnees and children living in IDP camp settings.
  • To improve availability of sexual health information to adolescents via informal education systems.

Core Components:

  • The 'wayo' facilitated an integrated approach and increased focus on improved sex education, and emphasized the important linkages between sexuality, family planning and the transmission of HIV/STDs.
  • The 'wayo' also helped young girls and women reflect on factors contributing to HIV related vulnerability, anticipation of risk and developing avoidance strategies. Most importantly they are doing so in a manner that is completely consistent with the cultural expectations of the community.
  • Girls are utilizing the ‘wayo’ to gain access to STI treatment as well as access to HIV testing. Upon request, girls were escorted for treatment and follow up care.
  • The ‘wayo’ are important ‘go-betweens’ in identifying shifting trends in vulnerability among girls’ and women that might not otherwise be reported. Of concern to many women was the increased number of girls who were reporting incest related harm.

Noteworthy Results:

  • 53% of young girls aged 14-19 reported ever having sex; range in age of sexual debut is 9-19 years old
  • Only 13% of sexually active girls had ever used a condom; A girl’s first sex partner was more likely a student or subsistence agriculturalist than a soldier or military personnel
  • 75% of the sexually active girls reported ever being pregnant; 220 girls were currently in school and 295 girls were not in school
  • Girls who have had sex are 90% less likely to be in school than girls who are not sexually active
  • Girls who thought they could protect themselves from HIV/STDs are more than twice as likely to be in school when compared to girls who thought they could not protect themselves from HIV/STDs

Lessons Learned:

  • Abductees have different emotional and practical needs than girls who have never been abducted; however, they were also accessing ‘wayo’. This was an unexpected finding and future programming must better incorporate the needs of abducted girls into the training program.
  • Referrals only work if there is program availability and the girls are given an opportunity to provide leadership and input into serious scaling up initiatives.
  • Consultations must occur between the ‘wayo’ program, girls at risk and other NGO and service providers.